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en-usSun, 02 Aug 2015 15:41:02 -0500Wolters Kluwer Health RSS Generatorhttp://images.journals.lww.com/jpojournal/XLargeThumb.00008526-201507000-00000.CV.jpeghttp://journals.lww.com/jpojournal/pages/viewallmostemailedarticles.aspx
http://journals.lww.com/jpojournal/Fulltext/2012/10000/Reliability_and_Validity_of_Outcome_Measures_for.5.aspx
ABSTRACT: Objective: Studies of outcome measures for adults with upper limb amputation are lacking. Our purpose was to examine the measurement properties of the Modified Box and Block Test of Manual Dexterity (BB), the Jebsen-Taylor Test of Hand Function (JTHF), the Upper Extremity Functional Scale (UEFS), the satisfaction scale from the Trinity Amputation and Prosthetics Experience Scale measure (TAPES), and the Patient-Specific Function Scale (PSFS). Specifically we aimed to 1) estimate test-retest reliability, 2) calculate minimum detectable change (MDC), and 3) examine known group validity. Methods: Subjects were 73 adults with upper limb amputation from four study sites. We estimated test-retest reliability using intraclass correlation coefficient (ICC) (3,1), calculated standard error of the measurement, and MDC; assessed scale score distributions; and compared scores by level of amputation using analyses of variance. Results: The ICCs were 0.91 for BB, 0.68 to 0.92 for the JTHF subtests, 0.80 for the UEFS summary, 0.65 for UEFS use, and 0.86 for the TAPES. The MDC was 6.5 items for BB, 0.09 to 0.18 items per second for the JTHF subtests, 12 points for the UEFS summary, 0.39 for UEFS use, and 0.79 for TAPES. Floor effects were observed for the JTHF page turning, small items, and feeding subtests. Subjects with more distal amputation had better dexterity (p < 0.001), better self-reported function on the PSFS (p = 0.01), and greater prosthetic satisfaction (p < 0.05) as compared with persons with higher levels of amputation. Scores on the UEFS did not vary by amputation level. Discussion and Conclusion: The BB, JTHF, and TAPES are reliable and valid for use with adults with upper limb amputation. Further research is needed to examine the test-retest reliability of the PSFS. The UEFS was reliable, but summary scores do not take prosthetic usage into account. Further validation work is needed for this measure. Findings can be used to assist clinicians and researchers in choosing appropriate measures and in interpreting changes in scores with repeat administration.]]>Mon, 01 Oct 2012 00:00:00 GMT-05:0000008526-201210000-00005http://journals.lww.com/jpojournal/Fulltext/2013/07000/A_Variable_Impedance_Prosthetic_Socket_for_a.6.aspx
ABSTRACT: This article evaluates the design of a variable impedance prosthetic (VIPr) socket for a transtibial amputee using computer-aided design and manufacturing (CAD/CAM) processes. Compliant features are seamlessly integrated into a three-dimensional printed socket to achieve lower interface peak pressures over bony protuberances by using biomechanical data acquired through surface scanning and magnetic resonance imaging techniques. An inverse linear mathematical transformation spatially maps quantitative measurements (bone tissue depth) of the human residual limb to the corresponding prosthetic socket impedance characteristics. The CAD/CAM VIPr socket is compared with a state-of-the-art prosthetic socket of similar internal geometry and shape designed by a prosthetist using conventional methods. An active bilateral transtibial male amputee of weight 70 kg walked on a force plate–embedded 5-m walkway at self-selected speeds while synchronized ground reaction forces, motion capture data, and socket-residual limb interface pressures were measured for the evaluated sockets. Contact interface pressure recorded (using Teksan F-Socket™ pressure sensors) during the stance phase of several completed gait cycles indicated a 15% and 17% reduction at toe-off and heelstrike, respectively, at the fibula head region while the subject used a VIPr socket in comparison with a conventional socket of similar internal shape. A corresponding 7% and 8% reduction in pressure was observed along the tibia. Similar trends of high-pressure reductions were observed during quiet single-leg standing with the VIPr socket in comparison with the conventional socket. These results underscore the possible benefits of spatially varying socket wall impedance based upon the soft tissue characteristics of the underlying residual limb anatomy.]]>Mon, 01 Jul 2013 00:00:00 GMT-05:0000008526-201307000-00006